Provider Demographics
NPI:1295112688
Name:GARVEY, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:GARVEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 JOLLY RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3680
Mailing Address - Country:US
Mailing Address - Phone:517-574-5628
Mailing Address - Fax:517-574-5619
Practice Address - Street 1:2525 JOLLY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3680
Practice Address - Country:US
Practice Address - Phone:517-574-5628
Practice Address - Fax:517-574-5619
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501000912237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist